Dual Eligibles

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Enticing Dually Eligible Beneficiaries to Enroll in Integrated Care Plans

The Financial Alignment Initiative (FAI) is intended to improve the quality of care and reduce spending for low-income people who are dually eligible. Mathematica researchers conducted a study to identify reasons for the varying participation rates across states. This brief explores the details of two major factors: passive enrollment and demonstration/MLTSS alignment.

Short URL: http://www.advancingstates.org/node/71771

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Information Sharing to Improve Care Coordination for High-Risk Dual Eligible Special Needs Plan Enrollees: Key Questions for State Implementation

This technical assistance tool focuses on the new “information sharing” requirement for Dual Eligible Special Needs Plans beginning in 2021. The tool explains the new requirement as well as how to address the requirement in mandatory D-SNP contracts.

Short URL: http://www.advancingstates.org/node/71731

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Integrated Care for People with Medicare and Medicaid: A Roadmap for Quality

To understand both the needs of people who use long-term services and supports (LTSS) through Medicare and Medicaid coverage and ways to apply quality measurement to this population, the National Committee for Quality Assurance (NCQA), supported by The SCAN Foundation, developed a roadmap for evaluating the quality of integrated care for dual eligibles.

Short URL: http://www.advancingstates.org/node/70199

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How States Can Better Understand their Medicare-Medicaid Enrollees: A Guide to Using CMS Data Resources

The CMS Medicare-Medicaid Coordination Office (MMCO) regularly reports data on Medicare-Medicaid enrollee demographics, service utilization, spending, and other characteristics that can give states a more comprehensive view of this population. This tool shows states how to use these data to create tables, graphs, and figures and interpret their meaning for a wider audience of stakeholders.

Short URL: http://www.advancingstates.org/node/70138

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Top 10 Recommendations to Strengthen Integrated Care: Lessons from California’s Dual Eligible Demonstration

This brief from the SCAN Foundation summarizes lessons learned and offers recommendations for improving integrated systems of care for people with Medicare and Medicaid, also known as dually eligible individuals. The brief draws from three years of California’s Cal MediConnect evaluation results.

Short URL: http://www.advancingstates.org/node/69833

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ACAP Medicare-Medicaid Plans and the Financial Alignment Demonstrations

The Center for Health Care Strategies (CHCS) published their report, “ACAP Medicare-Medicaid Plans and the Financial Alignment Demonstrations: Innovations and Lessons”, that was prepared for the Association for Community Affiliated Plans (ACAP). The report examines the experiences of 14 ACAP plans that are participating in capitated model demonstrations for the Centers for Medicare & Medicaid (CMS) Financial Alignment Initiative.

Short URL: http://www.advancingstates.org/node/68083

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Better Outcomes for Dually Eligible Older Adults through Integrated Care

The Department of Health and Human Services (HHS) published a report about the Minnesota Senior Health Options (MSHO) program. The Centers for Medicare and Medicaid Services (CMS) and the State of Minnesota started MSHO to coordinate the Medicare and Medicaid benefits their members receive, including Medicare coverage of acute medical care and Medicaid coverage of long-term services and supports. The report includes documentation of MSHO's outcomes from years 2010 to 2012.

Short URL: http://www.advancingstates.org/node/68017

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